PlymouthSchools & Academies

Access Bursary

2014-15

Version and date Not protectively marked OR Protect OR Restricted

16-19 Bursary Fund Application – Category 1& 2

INTRODUCTION

  • PRIOR TO COMPLETING THIS FORM PLEASE READ THE GUIDANCE NOTE.
  • HEADS OF POST 16 WILL NEED TO HAVE EVIDENCE OF ENTITLEMENT BEFORE APPROVING THE FORM.
  • PLEASE COMPLETE THIS FORM IN CAPITALS AND IN BLACK OR BLUE INK.
  • PLEASE ENSURE THE APPLICATION IS COMPLETE BEFORE SUBMITTING IT.

Student/Learner – Personal Details

Surname/Family Name:
First Names:
Date of Birth / Age on 01/09/2014
Address
Post Code
Contact Number
School/Academy name
School Year (Please circle) / Yr12 Yr13 Yr14
Title of course/subjects studied

Bank or Building Society Details

To receive payments, you must have a bank account in your own name that will accept BACS payments. If you do not have a bank account, you will need to open one for when you return in September.
Name of Account Holder
Name of Bank e.g. HSBC
Branch e.g. City Centre
Sort Code (6 digits only) /
Account Number (8 digits only) /

Application for Bursary

(Please tick where appropriate)

Category 1

Students aged under 19 on 31/08/14 and who fall into one of the following categories:

Are currently in care (as defined by social services)
Are leaving or have recently left care
Are in receipt of Income Support / Universal Credit in their own name
Are disabled and in receipt of both Employment Support Allowance and Disability Living Allowance / Personal Independence Payment – in their own name

Students within this category will receive a bursary award of £1200. Payments are made throughout the year and are subject to continued attendance/performance/attitude to studies.

Category 2

Students aged under 19 on 31/08/14 and who fall into the following category:

Claiming free School Meals (please refer to notes in guidance if you are unsure of this)

Students within this category received a bursary award of £750 in 2013/14, the amount for 2014/15 is likely to be a similar, however we will not be able to confirm the figure until applications are assessed in the autumn term. The amount will be confirmed before the end of September.

Payments are made throughout the year and are subject to continued attendance/performance/attitude to studies.

Please can you confirm if you were in receipt of a Bursary award for the academic years 2012-13 or 2013-14. Please tick the relevant category:

Category 1

Category 2

Category 3

Exceptional Case

No bursary received

Use of bursary funds

Please indicate in the table below how the bursary award will support your continued studies/education. You may be asked to provide evidence of expenditure.

(You may complete multiple boxes as appropriate)

Estimated Cost
Books/equipment
Additional course costs, e.g. trips
Transport
Meals
Accommodation
Exam re-sit fees
Other educational items – please specify

I confirm that:

  • The details above are true and accurate.
  • I understand that continued payments are dependant on meeting my School’s/Academy’s attendance and behavioural policy.
  • I am not currently in receipt of a 16-19 bursary from another provider.

Student Signature / Date
Parent/Guardian Signature / Date

Please return completed form to your sixth form office with the relevant evidence attached which is stated in the guidance notes by the before the end of the academic year

For completion by the Head of Post 16

I confirm that I have attached the relevant evidence for the category of support, and that the student named above:

  • Will be on a course of 30 weeks or more.

Head of Post 16 Name / Head of Post 16 Signature / Date